This interim report presents the data from a prospective study of BioHorizons, a bone quality–based implant system, with four implant designs. The surgical survival of 975 implants was 99.4%, with the survival 100% for D4 bone. Three critical phases of crestal bone loss have been identified: bone remodeling fromstage I to stage II surgery; stage II uncovery to prosthesis delivery (transition period); and prosthesis delivery up to the first year of loading (early loading bone loss). The stage I to stage II uncovery crestal bone remodeling resulted in a mean vertical bone loss of 0.21 mm to 0.36 mm (SD = 0.90 mm), dependent on whether the implant became exposed in the oral cavity during osseous healing. No statistically significant difference was found among the four implant designs, diameter, bone density, or location. The stage II to prosthesis delivery mean vertical bone loss ranged from 0.12 mm to 0.20 mm. One hundred threeconsecutive patients (partially and totally edentulous) were restored, with 360 implants and 105 prostheses in function for a period of 12 to 26 months. No early loading implant failure occurred, and all patients with implants are in satisfactory to optimum health according to the Misch Implant Quality Scale. The mean early loading bone loss was 0.29 mm (SD = 0.99 mm). Past clinical reports in the literature indicate most failures or crestal bone loss occur by the first year of loading. This study suggests the bone quality based dental implant design minimizes overall implant failure and crestal bone loss, regardless of bone density.